The management of suicide and self-harm in prisons: Recommendations for good practice

The number of women involved in the criminal justice system is growing, yet few programs and services are geared specifically towards their needs. Moreover, even with gender‐specific programming, a risk management model (Andrews & Bonta, 1998) has dominated rehabilitation policy, where criminogenic needs or harm avoidance have been the primary focus. Development of a theoretical approach that embraces gender‐specific treatment and addresses the realities of women's lives is critical. This paper posits that the enhancement model (Ward & Stewart, in press) provides such a framework to guide the construction of rehabilitation programs for female offenders. This model moves away from focusing on criminogenic needs, and instead emphasises enhancing offender capabilities to assist women in living balanced and fulfilling lives. A review of female‐specific treatment needs encompassed within the enhancement model is therefore outlined, including issues of physical and sexual abuse, mental health, children and families, vocation, life skills and substance abuse. The integration of these needs into a holistic rehabilitation framework conceptually based on the enhancement model is then proposed. We argue that this framework is fundamental to reducing female recidivism, and improving women's wellbeing and overall quality of life.

Section: Treatment Needs Of Female Offendersmentioning

confidence: 99%

Treatment needs of female offenders: a review

Sorbello

Eccleston

Ward

et al. 2002

“…Many offenders experience intense emotional pain and distress that originates in adverse childhood experiences. Specifically, family disruption, divorce, antisocial influences, physical and sexual abuse, school and vocational failure, poor parenting, and substance abuse, characterise these individuals' lives (Forth & Mailloux, 2000;Howells, Hall, & Day, 1999;Monahan et al, 2001), with greater prevalence of childhood sexual abuse among women offenders than men (Grayston & De Luca, 1999;Pollock, 1998;Thomas & Pollard, 2001). Criminality aside, this developmental history predicts a range of interconnected mental health problems in adulthood, including antisocial personality disorder (APD) and borderline personality disorder (BPD), and comorbid substance-related and depressive disorders (McCann, Ball, & Ivanoff, 2000).…”

mentioning

confidence: 99%

“…Offenders' maladaptive functioning often culminates in recurrent suicidal ideation and selfharm. Specifically, the stresses of arrest, remand and trial, are exacerbated by experiences emanating from the prison environment, such as bullying, violence, intimidation, disempowerment, social isolation and segregation, that further elevates the risk of dysfunctional behaviours (Howells et al, 1999;McCann et al, 2000).…”

mentioning

confidence: 99%

The RUSH program — real understanding of self-help: a suicide and self-harm prevention initiative within a prison setting

Eccleston

Sorbello

2002

s a consequence of adverse childhood experiences, offenders can develop mental health problems consistent with a diagnosis of borderline personality disorder (BPD). This is characterised by difficulties with distress tolerance, emotional and behavioural regulation, and interpersonal skills, that often manifests as recurrent suicidal ideation and self-harm. The dynamic interaction between the prison environment, offender psychopathology and individual coping styles further elevates this risk for suicide and self-harm. There are few treatment programs with proven efficacy in managing borderline characteristics with the exception of dialectical behaviour therapy (DBT) developed by Marsha Linehan (1993a) for clinical populations. However, the development, implementation and evaluation of forensic-based DBT programs is in its infancy. The RUSH (Real Understanding of Self-Help) Program is a recent Australian DBT adaptation targeting vulnerable offenders exhibiting borderline characteristics. This paper provides an in-depth exploration of RUSH, highlighting the modifications made to the original DBT framework. Therapeutic obstacles associated with implementing RUSH in a correctional environment are discussed, together with successful strategies to overcome these difficulties. Finally, examination of quantitative and qualitative outcomes suggests that RUSH is a promising, holistic offender rehabilitation program targeting BPD characteristics and related problem areas.

“…InPsych ("Suicide in Australia," 1999) recently featured the article "Suicide in Australia: Who Helps the Helpers?". Similarly, Howells, Hall, and Day (1999) raised this issue for those working within prison contexts. The question of who cares for the carers is worth reiterating as the final part of this response to the APS discussion paper on suicide.…”

Section: Psychologist Self-carementioning

confidence: 99%

“…"Because of the intense nature of this work, many clinicians argue that supervision and consultation are crucial" ("Suicide in Australia," 1999, p. 28). Howells, Hall, and Day (1999) highlight the need for research as to the most effective set-up for debriefing following suicide. While group-based interventions suggest better effectiveness following traumatic events (Chemtob, Tomas, Law, & Crernniter, 1997), there remains a dearth of information.…”

Section: Psychologist Self-carementioning

confidence: 99%

A Response to the Australian psychological society discussion paper on suicide

Garvey

2000

This response to the Australian Psychological Society's discussion paper on suicide reinforces the call for ongoing and appropriate psychological involvement with Indigenous Australians. It concurs with the observation that that the opportunities for involvement are many, but recommends that all must be considered within historical and contemporary contexts. Additionally, the sensitive nature of suicide for many Indigenous people and communities highlights the priority of establishing good working relationships as a precursor to research, clinical, and preventative involvement. Dilemmas likely to confront those considering involvement are described and the importance of psychologist self‐care within such involvement is highlighted and strategies considered. In conclusion, it is acknowledged that while involvement and even interest in suicide may vary amongst psychologists, a reading of the APS discussion paper on suicide provides a solid reference and good starting point for informing that involvement, particularly in relation to Indigenous youth suicide.